Objective To explore the protective effect of reduced glutathione (GSH) for cardiotoxicity caused by Epiru-bicin (EPI). Methods Sixty cases of female patients with breast cancer admitted to the First Hospital of Shijiazhuang City from January to December 2013 were selected and divided into two groups according to random number table. Thirty cases of EPI group were taken chemotherapy regimen of Cyclophosphamide combined with EPI, of which, Cy-clophosphamide 0.8 g, intravenous injection in the first day; intravenous drip of EPI 90 mg/m2 for equal division of ad-ministration in the first, eighth day respectively. Thirty cases of GSH+EPI group were given GSH 1500 mg/m2+5% glu-cose 250 mL on basis of chemotherapy regimen above, intravenous drip for 15 min, from the first day of chemotherapy, once a day, continued for 8 d. 21 days were as one course, for 6 courses continuously. After treatment, the ECG, ultra-sonic cardiogram, cardiac troponin T (cTnT), myocardial enzymes of the two groups were detected. Results ①The ab-normality rate of ECG in EPI group was higher than that of GSH+EPI group, the difference was statistically significant (P<0.05).②Compared with EPI group, the left ventricular ejection fraction (LVEF) of GSH+EPI group was higher, the level of cTnT was lower, the differences were statistically significant (P<0.05).③The levels of creatine kinase (CK), crea-tine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH) after chemotherapy in the two groups were all decreased sig-nificantly compared with before chemotherapy (P<0.05);compared with GSH+EPI group, the levels of CK, CK-MB, LDH in EPI group were decreased more significantly, the differences were statistically significant (P < 0.05). Conclusion GSH can improve the abnormality rate of ECG, LVEF and levels of cTnT of patients undergoing chemotherapy, and slow down the decrease of myocardial enzymes.%目的：探究还原型谷胱甘肽(GSH)对表阿霉素(EPI)所致的心脏毒性的临床保护作用。方法选取石家庄市第一医院2013年1~12月收治的乳腺癌患者60例,均为女性,采用随机数字表法将其分为两组。EPI组30例,采用环磷酰胺+EPI的化疗方案,其中环磷酰胺0.8 g,第1天静脉推注；EPI 90 mg/m2,分别于第1、8天等分静脉滴注。 GSH+EPI组30例,在上述化疗方案的基础上给予GSH 1500 mg/m2+5%葡萄糖250 mL,静脉滴注15 min,从化疗第1天起,1次/d,连用8 d。21 d为1个化疗周期,连续化疗6个周期。治疗结束后,对两组患者进行心电图、超声心动图、心肌肌钙蛋白T(cTnT)、心肌酶谱水平的检测。结果①EPI组心电图异常率明显高于GSH+EPI组,差异有统计学意义(P<0.05)。②与EPI组比较,GSH+EPI组左心室射血分数(LVEF)较高,cTnT水平较低,差异有统计学意义(P<0.05)。③两组患者化疗后肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平均较化疗前显著下降(P<0.05)；与GSH+EPI组比较,EPI组CK、CK-MB、LDH水平降低更明显,差异有统计学意义(P<0.05)。结论 GSH能够改善化疗患者的心电图异常率、LVEF及cTnT水平,减缓其心肌酶谱水平的下降。
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